Managing Intradialytic Hypotension: A Clinical Challenge

World Congress of Nephrology (ASN/ISN), San Francisco, CA, October, 2001
Access to this program is free but HDCN free zone registration is required.
Introduction: Setting the Stage
Martin J. Schreiber, Jr, MD
Intradialytic Hypotension (IDH): Pathophysiology
John T. Daugirdas, MD
Modifying the Dialysis Prescription to Reduce IDH
Richard A. Sherman, MD
New Therapies for IDH
Mark A. Perazella, MD, MS
Closing Comments  (Andrew King, MD)
Questions and Answers

After participating in this activity, participants should be able to:

Outline the potential mechanisms leading to increased morbidity/mortality from IDH.
Describe the physiological events occurring within major functional systems (cardiovascular, neurological, hormonal) during hemodialysis that can lead to IDH.
Identify the different treatments for maintaining BP during dialysis, and the rationale for each.
Recognize and select the components of the dialysis prescription which can be modified to decrease the risk for IDH.
Discuss the pros and cons of various pharmacological treatments for IDH.

John T. Daugirdas, MD
Professor of Medicine
University of Illinois at Chicago School of Medicine

Andrew J. King, MD
Division of Nephrology
Scripps Clinic

Mark A. Perazella, MD, MS
Associate Professor of Medicine
Director of Acute Dialysis Services
Yale University School of Medicine

Martin J. Schreiber, Jr, MD
Department of Nephrology and Hypertension
The Cleveland Clinic Foundation

Richard A. Sherman, MD
Director of ESRD Services
University of Medicine and Dentistry of New Jersey
Robert Wood Johnson Medical School

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Professional Postgraduate Services® (PPS) and Advanced HealthMarket Strategies™, divisions of Physicians World/Thomson Healthcare.

PPS is accredited by the ACCME to provide continuing medical education for physicians.

PPS designates this educational activity for a maximum of 2 hours in category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those hours he/she spent in the educational activity.

Post-test and evaluation form are at this link, but you must listen to all four talks from this symposium prior to completing the test.
STATEMENT OF NEED :
Intradialytic hypotension (IDH) is a distinct syndrome affecting as many as 20% to 50% of patients undergoing hemodialysis. Patients developing IDH require a significantly higher acuity of care. In addition to causing nausea, vomiting, cramping, dizziness and fatigue, IDH may also be associated with cerebrovascular insufficiency, cardiac instability, and thrombosis. To lower these risks, it is critical to fully understand the physiology of IDH and its treatment.

TARGET AUDIENCE :
This program is designed for clinicians who are involved in the care of hemodialysis patients who experience IDH.

FACULTY DISCLOSURE STATEMENTS :
Professional Postgraduate Services® (PPS) and Advanced HealthMarket Strategies™, divisions of Physicians World/Thomson Healthcare has a conflict of interest policy that requires course faculty to disclose any real or apparent commercial financial affiliations related to the content of their presentations/materials. It is not assumed that these financial interests or affiliations will have an adverse impact on faculty presentations; they are simply noted here to fully inform participants.
Dr. Schreiber has indicated a financial interest or affiliation as follows: Honoraria: Baxter Healthcare Corporation.
Dr. Daugirdas has indicated no significant financial interests or affiliations.
Dr. Sherman has indicated no significant financial interests or affiliations.
Dr. Perazella has indicated a financial interest or affiliation as noted: Consultant/Speaker: Shire US, Inc.
Dr. King has indicated no significant financial interests or affiliations.

DISCLOSURE OF UNLABELED USE ASN/HDCN (if applicable):
This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by FDA. Professional Postgraduate Services® (PPS) and Advanced HealthMarket Strategies™, divisions of Physicians World/Thomson Healthcare, ASN, HDCN do not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings.

All of the agents overviewed in this virtual symposium will be discussed in the context of uses for which they have not been approved by the FDA.


This educational activity is supported by an educational grant from Shire US, Inc.
This activity has been planned and produced in accordance with the ACCME Essential Areas and Policies.
This educational activity is based on an ASN/ISN evening symposium which was
planned by the World Congress of Nephrology program committee.
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